# Quality Improvement Project to Develop a Pictorial Chronic Obstructive Pulmonary Disease (COPD) Action Plan

## TL;DR

This study created a pictorial COPD action plan to help patients better understand and manage their condition, resulting in improved knowledge and satisfaction.

## Contribution

The novel contribution is the development and validation of a pictorial COPD action plan to enhance patient understanding and self-management.

## Key findings

- Pictorial COPD action plans improved patient knowledge scores by 92.8%.
- Patient satisfaction increased from 44% to 100% after using the pictorial plan.
- 63.6% of patients referred back to the pictorial plan three months later.

## Abstract

Introduction

Chronic obstructive pulmonary disease (COPD) is a global health concern and a leading cause of morbidity and mortality worldwide. COPD action plans help patients manage exacerbations by recognizing symptoms early and taking necessary steps. We found our COPD written action plan difficult to understand, potentially affecting the patient’s ability to self-manage their COPD.

Aims

We aim to design a new COPD action plan to increase the knowledge scores of our patients during competency checks by 20%.

Methods

We employed the quality improvement methodology of needs analysis and root cause analysis and used a Pareto chart to identify the top four contributory factors to an ineffective COPD action plan. These include being too wordy, lacking pictorial illustrations, being only available in a single language (English), and too much medical jargon. Using the prioritization matrix to assess possible solutions, the team decided to implement a pictorial COPD action plan. After two cycles of Plan-Do-Study-Act, the final pictorial COPD plan was compared with the original written action plan.

Results

Ten English-speaking COPD patients from our outpatient respiratory clinics were surveyed with the original action plan while 11 more were surveyed after the introduction of the pictorial action plan. There was an improvement in mean knowledge scores by 92.8% (t(19) = 6.67, p < 0.01, at 95% CI). Patient satisfaction rates also increased from 44% to 100%. Sixty-three percent (63.6%) of patients surveyed said they referred back to the pictorial action plan 3 months after being introduced to it.

Conclusion

Pictorially enhanced COPD action plans have been shown to improve our patients’ knowledge of COPD self-management.